On the cerebro-spinal origin and the diagnosis of the protrusion of the eyeballs termed anaemic / by Thomas Laycock.

  • Laycock, Thomas, 1812-1876.
Date:
1863
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Licence: Public Domain Mark

Credit: On the cerebro-spinal origin and the diagnosis of the protrusion of the eyeballs termed anaemic / by Thomas Laycock. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    character to disappear.1 This remark applies, indeed, equally to the other alleged signs and symptoms of anaemia; they may all result from disorder of the nervous system. The same mistake in diagnosis is made as to the causes of, and the condition of the blood in, purpura and purpura hsemorrhagica. These are often consecutive to leukaemia and the worst forms of spansemia, and are almost pathognomonic of the blood degeneration known as scorbutus ; hence it was concluded, and indeed is still very generally held, that they are always connected with cachectic conditions. Yet, Dr Parry showed, fifty years ago, that there was a sthenic form of purpura to be relieved by blood-letting and antiphlogistics, which came on in persons who had been in no degree or manner exposed to the causes of scorbutus.2 Further, there are some fallacies as to the causes of an asm i a itself. In many of the recorded cases of anaemic exophthalmos, nay, in the majority, the patient was first subject to conditions mental or bodily which power- fully influenced the nervous system, then nervous symptoms arose, and then anaemia. Here the chain of events points to a morbid condition of the nervous system as the cause of the anaemia. That blood degenerations arise in this way is, I venture to say, as certain as that they arise from the causes ordinarily specified. There are two forms of anaemia, it will be admitted by all, in which cardiac and vascular symptoms like those we have been con- sidering do certainly occur. The one is that which follows upon very profuse loss of blood during parturition, and the other the anaemia of young women, termed chlorosis. But it is a very significant fact, that in the haemorrhagic form the vascular disturb- ance is not restricted to the vessels of the head and neck, as it is in the disease under consideration, while in the chlorotic there are circumstances in the causation and course which render it doubtful whether it should not be classed with that disease. There is one sign, however, which merits special notice, because it is of as frequent occurrence as either the blood-defect or the vascular and nervous symptoms, and that is the increased production of heat. It is usually described as flushings or burnings, but it occasionally is so great as to excite a longing for cool air, or u air-hunger,” as the Germans term it.3 Now this is exactly like what is seen in cases of hasmorrhagic anaemia, in which the increased heat of body is most distressing to the patient. And it is most significant of the true character of this symptom, that this morbid increase of tem- perature is not only sometimes a certain forerunner of death, but in one class of cases is observed to take place after death, as in epi- demic cholera and yellow fever. Perhaps the most striking example of this kind on record, is one mentioned by Dr Davy in his recently 1 Clinical Lecture on Physiognomical Diagnosis. Med. Times and Gazette May 31, 1862. 2 Edinburgh Medical and Sui'gical Journal, vol. v. p. 7. 3 Such a case of chlorotic exophthalmia is detailed by Withusen, in Dr Moore’s Translation, Dublin Medical Press, July 13, 1859.